ulcer_history_presentation final bds.pptx

oral medicine and radiology

1. Recording Ulcer History Nithika V Nair T hird year

2. content Introduction Points to be recorded in ulcer history Summary

3. Introduction Ulcers are among the most frequent oral lesions encountered in dental practice. They may arise from simple local trauma or represent manifestations of systemic, infectious, immunological, or even malignant conditions. In oral medicine and radiology, accurate and systematic recording of ulcer history is crucial because the oral cavity often reflects both local pathology and underlying systemic disease. A well-documented history helps in: Distinguishing between acute, recurrent, and chronic ulcers. Identifying predisposing factors such as trauma, infection, or systemic illness. Correlating clinical findings with radiological and laboratory investigations. Thus, history-taking forms the foundation of diagnosis, treatment planning, and prognosis in the management of oral ulcers.

4. Points to be recorded in ulcer history 1. Number 2. Site 3. Duration 4. Progression 5. Associated symptoms – pain, pus discharge 6. Recurrences (number and frequency) 7. Interference in functions 8. Any preceding events 9. History of ulcer elsewhere in the body

5. Number Single ulcers Aphthous ulcer Traumatic ulcer Histoplasmosis Blastomycosis Mucormycosis Whether the ulcer is single or multiple. Aphthous ulcer

6. Multiple ulcers: Herpes virus infections Varicella-zoster infection Coxsackie virus infections Erythema multiforme Stevens-Johnson syndrome Aphthous ulcer Pemphigus vulgaris Pemphigus vegetans Mucous membrane pemphigoid Herpes zoster presenting with multiple ulcer

7. Site Where was the ulcer first noticed? Site gives a clue to the pathology: Aphthous ulcers → Non-keratinizing mucosa (lips, buccal mucosa, soft palate) Herpes simplex → Keratinizing mucosa (hard palate, marginal gingiva) Traumatic ulcer → At site of trauma Ask for similar ulcers in other parts of the body (in mucocutaneous diseases): Pemphigoid → Eye, skin Pemphigus → Skin Bechet syndrome → Genital, skin Erythema multiforme → Skin Stevens-Johnson syndrome → Genital, skin, eye Pemphigoid

8. Duration Acute ulcer: ≤ 10 days Chronic ulcer: > 10 days Traumatic ulcer can be acute or chronic Acute ulcers: Herpes virus infections Varicella-zoster infection Coxsackie virus infections Erythema multiforme Stevens-Johnson syndrome Aphthous ulcer Traumatic ulcer Erythema multiforme

9. Chronic ulcers: Pemphigus vulgaris Pemphigus vegetans Mucous membrane pemphigoid Traumatic ulcer Histoplasmosis Blastomycosis Mucormycosis Pemphigus vulgaris

10. Progression Has the ulcer increased or decreased in size? Rapid or gradual progression? Malignant ulcer → increases in size, depth, width Aphthous ulcer → heals in 1–2 weeks Spread to other parts of the body? (e.g., pemphigus)

11. Associated Symptoms Painful ulcers: Aphthous ulcer Painless ulcers: Syphilitic ulcer, early malignant ulcer Pus discharge

12. Recurrences Has ulcer recurred in the same or other site? Association with triggers: Trauma Cold Light exposure (sunlight)

13. Interference in Functions Does ulcer affect: Mouth opening / talking Eating Speech Swallowing Examples: traumatic or malignant ulcers

14. Preceding Events Trauma → Traumatic ulcer Chemical use → Chemical burn Hot food → Thermal burn Prodromal features (fever, burning sensation) → Viral infection Stress → Psychosomatic ulcer (aphthous etc.)

15. Summary A systematic approach in recording ulcer history is essential. Record details such as: number, site, duration, progression, symptoms, recurrences, functional interference, preceding events, and ulcers elsewhere in the body. This helps in accurate diagnosis and ensures better treatment outcomes.